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The Research Question

The Research Question. Clinical Effectiveness of Collaborative Care Management For Depression Over Time Garrison, GM; Angstman, KB; O ’ Connor S; Williams MD; Lineberry TW

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The Research Question

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  1. The Research Question Clinical Effectiveness of Collaborative Care Management For Depression Over Time Garrison, GM; Angstman, KB; O’Connor S; Williams MD; Lineberry TW • How much more quickly do depressed patients treated with Collaborative Care Management (CCM) improve when compared to usual care (UC)? • Why this is important? • We know CCM is superior to UC at 6 and 12 months • But, patients care about how quickly treatments improve symptoms • Survival analysis can tell us how quickly patients treated with CCM vs. UC improve

  2. What the Researchers Did • Retrospective Cohort of 7,340 patients diagnosed with major depression or dysthymia from 3/08-6/13 • Taken from primary care practice of over 100,000 • Bipolar disorder excluded • Enrollment in CCM was patient/primary MD decision • Survival Analysis of subsequent PHQ-9 scores • Remission: PHQ9 < 5 • Persistent Depressive Sx: PHQ9 >= 10

  3. What the Researchers Found Median Time-to-Remission (p<0.001) CCM: 86 d (95% CI: 81-91) UC: 614d (95% CI: 565-692) Median Time-with-PDS (p<0.001) CCM: 31 d (95% CI: 30-33) UC: 154 d (95% CI: 138-182)

  4. What This Means for Clinical Practice • Patients care about how quickly they improve • CCM shows improvement over UC within 1st month • Non-randomized study may be biased due to self-selection and sampling • Survival Analysis may be superior to Logistic Regression at fixed endpoint for comparison of many chronic disease treatments

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